Cultural competence and safety in Circumpolar countries: an analysis of discourses in healthcare

Figures & data

Table 1. Circumpolar Indigenous contexts [33–46]

Jurisdiction	Indigenous population, total population (% of total population)	Indigenous nations	Access to Indigenous-centric services
Alaska, USA	737,438, 112,828 (15.3%)	228 federally recognised tribes, including Iñupiat, Yupik, Siberian Yupik, Sugpiaq, Unangax, Eyak, Tlingit, Haida, Tsimshian, and Athabascan	Alaska Native peoples may access healthcare through tribal, private, or military healthcare systems (dependent on military service history and Indigenous status) The Alaska Tribal Health System and Alaska Native Tribal Health Consortium provide Indigenous-centric PHC, secondary and tertiary care.
Yukon, Canada	8,195; 35,111 (23.3%)	Kutchin, Hän, Kaska, Tagish, Tutchone and Teslin	Indigenous peoples access the same publicly funded services as other provincial/territorial residents. PHC, secondary and tertiary care are provided at no cost to the individual. Some Indigenous nations offer culturally-defined prevention-oriented services to their members (Yukon and NWT). In Quebec and Labrador, Indigenous communities manage their own community-based PHC services and hospitals.
Northwest Territories, Canada	20,860, 41,135 (50.7%)	Deneh, Tłįchǫ, Slavey, Innuvialuit, Gwich’in, Sahtu, Métis
Nunavut, Canada	30,550, 35,580 (85.9%)	Inuit
Nunavik, province of Quebec, Canada	10,880, 7,965,450 (0.1%)	Although the overall province includes many nations, the circumpolar portion of the province includes primarily Inuit.
Labrador province of Newfoundland & Labrador, Canada	1,285 (Innu) and 6,450 (Inuit)/512,250 (1.5%)	Nunatsiavut Inuit, Innu, Nunatukavut Inuit
Greenland, autonomous constituent country of Denmark	50,171; 55,877 (89.8%)	Greenlandic Inuit or Kalaallit	Greenlandic Inuit access the same services as any other resident. There is no cost to access services. Services vary depending on place. For example, access to hospitals is limited to major cities and larger towns in Greenland. In remote settlements health stations are provided with severely limited services and trained staff.
Denmark	Estimated 16,470; 5,581,190 (0.30%)	Greenlandic Inuit or Kalaallit	Sámi access the same services as their national counterpart.
Sweden	Estimated 20,000–40,000; 10,230,185 (0.2–0.4%)	Sámi	Sámi access the same services as their national counterpart.
Finland	Estimated 9,000; 5,517,830 (0.2%)	Sámi	Sámi access the same services as their national counterpart.
Norway	Estimated 55,544; 5,295,619 (1.0%)	Sámi	Sámi access the same services as their national counterpart. Limited to the Saami Norwegian National Advisory unit on Mental Health and Substance Use (SANKS)
Russia (Regions of Muyrmansk Oblast, Kareliya Republic, Arkhangelsk Oblast, Nenet Autonomous Okrug (AO), Komi Republic, Yamalo Nenets AO, Khanty-Mansi AO, Taymyr AO, Evenki AO, Sakha Republic, Magadan Oblast, Koryak OA, Chukotka AO)	Estimated 270,000; 146,000,000 (0.2%)	Aleuts, Alyutors, Chelkans, Chukchis, Chulyms, Chuvans, Dolgans, Enets, Siberian Yupik, Inuit, Evenks, Evens, Itelmens, Kamchadals, Kereks, Khanty, Koryaks, Kumandins, Mansi, Nanai, Negidals, Nenets, Nganasans, Nivkhs, Oroks, Orochs, Sámi, Selkups, Shors, Soyots, Taz, Telengits, Teleuts, Tofalars or Tofa, Tubalars, Tozhu, Udege, Ulchs, Veps, Yukaghirs Yakuts, Buryat, Komi and Tuvans do not have Indigenous status under Russian legislation	Indigenous-centric health services do not exist in Russia. Some efforts are directed to mobile medical complexes and centres and increased opportunities for air ambulance flights to remote places of indigenous peoples’ residence as well as training doctors and nurses of indigenous heritage.